Specialties
Finding Answers for a Growing Problem: Unresolved-Pain
Are you frustrated because your pain has not gone away yet? Although it is common for people to have ongoing pain and injuries, it becomes more frustrating when medical interventions, exercise, or rest do not fix or even alleviate your pain. Eventually, you find yourself still looking for solutions but start to lose hope because your pain limits your life with work, family or sports. We call this ‘Unresolved Pain’.
We find today’s health care is commonly based on a triage-based approach that looks to give you quick answers and remedies. Motion Stability believes, instead, that the key in successful pain resolution comes by taking the time to fully understand what is contributing to your pain and provide a comprehensive treatment plan to address the complexity of your pain.
You may think that your pain is due to just a structural problem such as a herniated disc, a bone spur, or strain in your tendon. Although they may be reasons why your pain persists, there is usually more to it. Motion Stability takes into consideration the involvement of four main categories or reasons that may contribute to your ongoing pain. They include: Types of Pain, Tissue Pathology, Movement Dysfunction, and the Internal Body. Our success in treating your pain comes by determining which of these categories may be involved, how they influence each other, and determining the priorities in focusing our treatment regimens. Even though your pain may be identical to somebody else’s, your pain is unique to the person you are and the life you live. We aim to tell you the story why your pain exists and an individualized plan to resolve it.
Whether you’re a weekend warrior or a professional athlete, Motion Stability offers specialized rehabilitation techniques and training strategies for your specific sport.
We understand that the success in rehabilitating an athlete from their injuries requires clinicians that understand the nature of your sport. This includes treating injuries that are unique to your sport, techniques and movements specific to your sport, and training regimens that are required to meet your performance goals. Feel free to contact us to ask how we can tailor your physical therapy program specifically to you.
Types of Pain
Not every pain is the same. Therefore, not every patient with pain should receive the same treatment. Most people would agree that a simple paper cutversus burning nerve pain in the leg are different types of pain. Actually in the ‘Pain Sciences’ literature, there is considered to be five major types of pain. Motion Stability feels the better we understand what pain is and the complexities each present, the more accurate our treatment regimens can be. Likewise, we feel the more you are educated on what pain is, the greater capacity you can resolve it.
To help you understand what the different types of pain are, we use the example of a common ankle sprain and the various symptoms you may experience with it. These examples of pain essentially can be applied anywhere in your body.
‘Just An Ankle Sprain..’
This is the ankle sprain most people experience. You turn your ankle playing basketball or tripping over something. It swells and is hard to walk on for a while, but soon enough the swelling goes down and you’re able to get running again. No big deal. It heals and you keep moving on. Pain sciences call this ‘Nociceptive’ pain. We all experience this type of pain somewhere in our body, whether it be a simple back strain, cut on the finger, or whiplash from a car accident that you’re able to bounce back from. This is the every day pain that gets better mostly on its own or with some health care intervention.
‘Why Is It Numb?’
You thought you just sprained your ankle, but now your foot or toes are numb or tingling. What was thought to be a simple ankle sprain has now affected the peripheral nerves around your ankle and leg. Nerves that get irritated can cause symptoms like numbness, tingling, burning, and even sensation or strength changes. Pain scientists call this ‘Peripheral Neurogenic’ pain. It is basically pain that affects nerves. Treatment for nerve pain is approached differently than a muscle or ligament due to it being extremely sensitive and connected directly to your spinal cord and brain.
‘It Hurts Just To Touch It!’
Although not as common, you may have sprained your ankle and find your injury is exceptionally sore to things that you would not expect it to be. Pain with things like light touch, heat, and cold are common with, what pain scientists call, ‘Central’ pain. Central pain is based at the spinal cord level and not at the peripheral injury site. Your spinal cord acts like a processing center that sends information from your external body and filters it to your brain to perceive. In normal circumstances, the spinal cord processes things without problems. However, there are cases when the processing centers of your spinal cord are altered and say a simple bump or even light touch can be severely painful. Central pain is complex in nature and continued research is being done.
‘It Is Really Swollen!’
There are rare cases when you sprain your ankle that it swells completely out of proportion. It turns really red, even purple, and sometimes even white. It becomes very painful to touch to the point that you cannot sleep with your bedsheets touching it. Diagnosis such as complex regional pain syndrome (CPRS), formerly known as reflex sympathetic dystrophy (RSD), is a common diagnosis for these types of symptoms. This pain is mostly driven by what pain scientists call‘Autonomic’ pain. Your autonomic nervous system controls your ‘fight or flight’ response or what you may experience when you hear a loud bang or life-threatening situation. Things like stress, anxiety, depression, hormonal imbalances can all affect the balance of the autonomic nervous system. When the autonomic nervous system becomes involved it can cause pain and swelling patterns that are exponentially worse. Treatment in these cases is focused on regulating the autonomic nervous system and not just simple rest and ice.
‘It’s All In Your Head!!!’
Your own perception of pain itself is influenced by so many factors. This could include your family or cultural upbringing, traumatic experiences, or your own motivations in life. Pain essentially is a perception that your brain detects. Just as every person has unique personalities, each person also perceives pain differently. This would help explain why two people with the same exact injury may have completely different reactions. We attribute the differences due to a person’s ‘Affective’ component – in which your own persona can affect the intensity or perception of pain that you feel. In this regard, it is vital that health practitioners take into consideration each person’s affect and provide treatments that consider how it influences the perception of your pain.
Tissue Pathology
In any orthopedic injury it is key to be able to diagnose the tissue or structure that is causing or contributing to your pain. Especially in recurring injuries,there is rarely one structure that is involved – but usually involves multiple tissues that affect each other. Motion Stability focuses on diagnosing the involved tissues and provide effective treatments to improve their integrity. This includes:
Soft-tissue:
Soft-tissue includes muscles, tendons, ligaments, fascia, or cartilage. There are manual tests we can perform to rule out involvement of any soft-tissue. For example, by manual palpation of muscle we can determine if there are myofascial trigger points, which in layman’s terms are ‘knots’ in the muscle. Trigger points are involved in causing myofascial pain, changing muscle function, and altering movement patterns. Treatments can include soft-tissue release techniques or intramuscular manual therapy (formerly known as trigger point dry needling).
Joint:
Joints guide the movement of any moving body part. If the joint loses mobility or has excessive mobility – increased stresses can occur causing pain in the joint or around its surrounding structures. Manual therapy, proper exercise prescription, and taping techniques are usually successful in improving joint integrity.
Nerve:
Nerve is disregarded many times as a tissue that can cause injury. When nerves inflame they can cause pain, numbness, and tingling. And just like any other connective tissue, nerves can lose their mobility causing restrictions in motion. Much or our research and publications are focused on nerve related injuries through techniques called ‘neurodynamics’. We focus on improving the mechanics and physiology of the nerve to restore it to its normal function.
Movement Dysfunction
All unresolved orthopedic injuries or pain involve a poor or prolonged movement dysfunction that places increased stress to your body. With repetition, soft-tissue, joints, and nerves can breakdown leading to injury and pain. Motion Stability examines not only how individual joints, muscles, and nerves work, but just as importantly how they synchronize together to provide efficient and safe movement in function and sport.
Posture and Gait:
The way you stand, sit, and walk reveals a lot about the reasons why you have pain. It also shows how a standardized protocol of exercises can only get a small percentage of people functioning properly. Each person has a unique way they move and hold themselves. Motion Stability focuses on providing specific exercises and manual techniqes to improve the individual’s needs for proper gait and posture.
Muscle Control:
There is a lost art of exercise. Many people think they know what exercises to do to improve their strength and flexibility. However, we find that patients get hurt due to overdoing or not doing exercises correctly. Certain muscles – usually the smaller ones closest to the joint – are designed to stabilize the joint, while larger muscles are designed to provide more force and power for movement to occur. The brain then coordinates the muscles together for a properly coordinated movement. Motion Stability focuses on improving the muscle control and integrating it with movement to provide efficient function.
Movement Patterns:
When it comes down to it all, the way you move guides how your joints and other tissues are used. Whether it is the way you were trained to play a sport, to a previous injury that makes you compensate in your movement, or a developmental pattern you had when you were a child – each individual has as a specific ‘movement pattern’ they use to perform a task or sport. Tissues can easily breakdown when the pattern is inefficient and can maintain a patient in their pain. Motion Stability strives to restore the patient to a safe and injury free pattern of movement in their function and sports they play.
Sports / Work Specific:
It is amazing how the smallest change in angle or modification to your technique in a sport or repetitive work activity can significantly reduce a patient’s pain. Motion Stability looks to coordinate with your coach, trainer, or instructor on their perspectives of the way they want you to move in your activity. We make recommendations based on how you physically present to make proper modifications to reduce the stress and improve your efficiency. We also have the ability to use 3D motion capture reality imaging – in collaboration with Fusion Atlanta (www.fusionatlanta.com) to analyze your movement from different angles and sequencing patterns.
Internal Body
You shouldn’t be surprised how much your internal health of your body affects your pain. This can include food allergies, vitamin and hormonedeficiencies, and systemic / internal organ dysfunction. Although Motion Stability does not perform physical tests to confirm their involvement, through our evaluation we are able to determine its possibility and their relationship to your pain. We then coordinate with the best health practitioners to rule out their contribution.
Vitamin / Hormone Deficiencies:
Deficiencies in Vitamin such as D, B6, B12 and hormones such as Thyroid-stimulating hormone (TSH) can affect your internal operating systems. With significant changes in levels, your body reacts with pain being a common effect. There are common characteristics your body presents with for each vitamin or hormone deficiency.
Nutrition / Food Intolerances:
The growing trend of people with food intolerances has revealed how food can contribute to someone’s pain. When food is processed in an organ, the intolerance can cause an adverse reaction with the nerve fibers around it. This contributes to a reflex called the viscero-somatic reflex that can stimulate the nervous system and provoke pain.
Systemic / Internal Organs:
Dysfunction in an internal organ such as the kidney or gall bladder can refer pain to the superficial skin. Although your pain may feel like it is coming from a muscle or joint it may be originating from within your internal organs or other systems. Coordination with specialized health practitioners is needed to rule out its involvement.
Sports & Wellness
Whether you’re a weekend warrior or a professional athlete, Motion Stability offers specialized rehabilitation techniques and training strategies for your specific sport.
We understand that success in rehabilitating an athlete with injuries requires clinicians that understand the nature of your sport. Our approach to treatment generally begins with treating the involved Tissue Pathologies in your body that are injured. Treatments often include manual therapy, dry needling, taping, and modalities. We also perform a comprehensive Movement Analysis that examines and identifies how the movement of your entire body, including your vision, can affect the way the body moves, especially in high-end performance. We tailor your sports specific rehabilitation program through corrective and functional exercises that strengthen the foundation of the muscles needed to stabilize your body during high-level performance as well as focusing on exercises that may be unique to your sport.
We are always happy to collaborate with your coach or trainer, as our goal is to help you fully integrate proper body mechanics and injury prevention into your training regimen. Motion Stability strives to do our best, as performance rehabilitation specialists, to play our part in helping you fulfill your potential again.
Sports Specific
Basketball
Motion Stability is the proud physical therapy provider for the WNBA Atlanta Dream as well as works with NBA, collegiate, high school and recreational basketball players. We specialize in assessing biomechanical inefficiencies in a player’s movements that may lead to injuries often experienced by basketball players, such as patellar tendinitis, Achilles tendinitis, hip or back pain as well as rehabilitation of ACL reconstructions and ankle sprains. Our goal is to help each athlete play pain free at full speed.
Golf
Motion Stability has a niche specialty practice in golf performance and rehabilitation. We have had the honor of working with PGA and LPGA players as well as competitive collegiate and youth golfers. We have also been published in Golf Magazine in both magazine and book formats.
Motion Stability provides specific interventions to treat ongoing injuries and pain related to the golf swing. We are able to assess a player’s specific body type in terms of the flexibility and strength required for the modern golf swing. We specialize in focusing on and improving the body mechanics required to allow the golfer to efficiently handle the amount of torque the body undergoes with the perfect swing.
Running
Many runners feel their injuries go away over time, or experience relief of reoccurring issues through treatments that are only temporarily effective. Motion Stability provides an in depth study of the clients running mechanics, how each runner’s body, joints, and muscles are working together to affect their running stride. We specialize in providing specific and individualized exercises and treatment focused on restoring proper strength and flexibility, addressing any biomechanical inefficiencies that may be present in the body, and integrating the runner back to their desired running programs.
Tennis
Motion Stability has worked with elite tennis players on both the professional and collegiate level, with a specialty in working with adolescent players aspiring to play in college and/or professionally. We have worked with the USTA as well as independent players and coaches to help tennis players with their specific injuries as well as helping players improve their overall playing performance with a focus on refining the body mechanics required to play the perfect match.
Triathlon
The injuries or pain a triathlete might experience are unique, because they may be related to the execution or training required for any one of the events involved, but most often are related to and affect the entire triathlon. Motion Stability examines the biomechanical tendencies of the triathlete, paying special attention for issues such as a weak hip, or a tight ankle that may ultimately be affecting an athletes run, bike, and swim. Ultimately we seek to rehabilitate your specific injury or source of pain and help you refine your full body mechanics to aide in efficient high level performance and endurance.
Swimming
Motion Stability has physical therapists on our staff that have swam collegiately, have coached swimming, and are recreational and competitive swimmers themselves. We understand the training and mechanics required for swimmers, as well as common problems in swimmers that may lead to injuries.
Soccer
Most soccer injuries tend to occur due to either direct contact such as collisions or repetitive action such as running, turning, or cutting. Whether your pain or injury in caused due to a traumatic event or repetitive strain, Motion Stability can effectively help you return to the soccer field. We are excellent with post-surgical care, and are also skilled diagnosticians of the causes of repetitive injuries such as hamstring strain, Achilles tendintis, plantar fasciitis, or hip pain. Our goal is to help you improve your efficiency, regain high-power speed and performance, and give you the tools to prevent future injuries.
Football
Football is one of the most popular sports played by young athletes, and it leads all other sports in the number of injuries sustained. In 2007, more than 920,000 athletes under the age of 18 were treated in emergency rooms, doctors’ offices, and clinics for football-related injuries, according to the U.S. Consumer Product Safety Commission. All the while, pressure increases for athletes to be bigger, run faster, and hit harder, pushing the limits of their bodies.
We Specialize In…
Conditions Treated
Motion Stability works with all orthopedic and performance injuries in the spine and extremities. Conditions we treat include, but not limited to:
Spine
- Neck/back pain
- Sacro-iliac joint (SIJ) pain
- Headaches / TMJ
- Thoracic outlet syndrome
- Sciatica
- Upper extremity numbness / tingling
Shoulder
- Rotator cuff dysfunction
- Frozen shoulder
- Post-surgery
- Overhead athlete injuries
Elbow, Wrist, & Hand
- Tennis / Golfer’s elbow
- Carpal tunnel syndrome
- Numbness / tingling / paresthesias
Hip & Knee
- Arthritis
- Hip impingement / bursitis
- Pirformis syndrome
- Patellar pain
- IT band syndrome
- Medial knee pain
- Hamstring strains
- Post-surgery
Ankle & Foot
- Ankle sprains
- Achilles tendinitis
- Shin splints
- Plantar fasciitis
Techniques
Movement Re-Education
The amount of support your body has will change the amount of control your body needs to exert to maintain its position. Poor motor control can be the cause of injuries. This poor movement pattern is not optimal for maintaining healthy joints and balanced muscles, so over time, these muscles wear down. At Motion Stability we do a thorough assessment to determine what patterns of movement might be contributing to your injury, pain, or less than optimal performance. We then teach you how to correct these patterns so you can optimize your function and performance and decrease your pain.
Dry Needling
Dry needling is an invasive procedure in which a solid filament needle is inserted into the skin and muscle directly at a myofascial trigger point. Physical therapists utilize dry needling in the treatment of myofascial pain.
Sports-Specific Training
Oftentimes the patient is rehabilitated from their injury or pain state and then discharged. However, the patient has not been conditioned to return to their occupation or back to playing competitively or recreationally. Many times, the work or sport movements are what originally caused the problem in the first place. At Motion Stability we focus on returning the patient so that they are performing optimally for their sport or work to prevent re-injury.
Manual Therapy
Manual therapy are hands on techniques used by our physical therapists to assess and treat movement dysfunction in the body. It includes a detailed assessment of the muscles, joints, fascia and nerves as well manually applied movement techniques such as joint mobilization, myofascial release, soft tissue mobilization and nerve mobilization to treat excessive and restricted movement. The therapists at Motion Stability have all taken post-graduate courses in orthopedic manual therapy.
Neurodynamics
Therapists at Motion Stability are specially trained in using nerve mobilization called ‘neurodynamics’ as a treatment approach to address nerve related pain and injuries. Neurodynamics is the integration of the mechanics and physiology of the nervous system in the manual treatment of neuromusculoskeletal disorders.
Ultrasound Imaging
At Motion Stability, we use rehabilitative ultrasound imaging to visualize muscle control, especially muscles that are difficult to see from the superficial skin. Such muscles in core stability such as the transversus abdominis, multifidus, and pelvic floor are key in providing proper core stability. Ultrasound imaging provides feedback to the patient whether the proper muscle contraction is being performed.
Redcord
Redcord, also known as Neurac, is a system that originated in Norway. Redcord is designed to help patients with musculoskeletal pain regain normal function by using high levels of neuromuscular stimulation. This is accomplished by suspending the patient in a series of slings and bungees that offload weight and allow the therapist to perform manual therapy techniques and gradually increase weight-bearing exercises while reducing or eliminating pain.
Modalities
Given the right clinical presentation, the use of modalities such as electrical stimulation, ultrasound and other interventions are appropriate to calm pain, muscle guarding, and promote healing. Our physical therapists utilize modalities in the appropriate time of your pain presentation.
Taping
Motion Stability is trained in various taping techniques to help facilitate, inhibit, or support musculoskeletal conditions.
Hip Specialties
“Specializing in Non-Replacement Hip Pathologies”
The hip can be a common cause of musculoskeletal pain. The hip can also be affected by the pelvis, low ath-hipback, as well as the lower extremity. Paingenerated from the pelvis and low back can refer into the hip and groin, which makes treatment difficult. Due to the complex nature of this area, patients with hip pain often struggle obtaining a proper diagnosis and treatment for their particular dysfunction.
Motion Stability practices a collaborative approach with the patient’s physician to obtain the optimal treatment strategies for the patient’s condition. Along with the physician’s assessment, the Motion Stability Physical Therapists will help to determine the myofascial and skeletal imbalances that are contributing to the patient’s condition. Whether it is conservative physical therapy management or post-surgical care, the physical therapists have the expertise to work efficiently with the patient and their physician towards the best outcomes for the patient.
Once the condition has been evaluated thoroughly including the hip structure, sensitive tissues, muscular imbalances as well any influences from the spine, pelvis, and lower extremity the therapist will construct a treatment plan guided by their findings. Many hip pathologies result from lack of strength and motor control of the hip stabilizers; glutes, iliopsoas, obturators and gemelli, to name a few. Therefore, treatment is a two-pronged approach that often focuses on manual therapy techniques to restore optimal mechanics of the hip, surrounding structures, and tissues and guided exercises to improve strength and coordination of the muscles used to stabilize the hip correctly within its socket. Once optimal mechanics of the hip are restored, the therapist will work with the patient to return him/her to their desired level of function and athletic endeavors. This may include collaboration with the patient’s parents, coaches, and trainers.
Labral Tears– The labrum is a ring of cartilage surrounding the hip socket to deep it and provide more stability for the joint. The labrum can be torn or irritated due to trauma or abnormal mechanics causing rubbing of the head of the femur on the rim of the joint. If the labrum is being treated conservatively (without surgery) treatment focuses on improving the mechanics of the joint to decrease any further degradation.
Impingement– (Femoroacetabular Impingement (FAI)) occurs when the ball and socket do not fit congruously together and the ball (femoral head) does not have adequate range of motion and rubs abnormally on the socket. Patients may be asymptomatic at first, but if left untreated the condition can progress to cartilage and/or labral damage.
Post-Surgical– The most common athletic hip surgeries are a result of cartilage and labral damage. These conditions can occur in combination or independently of each other. The Motion Stability Therapists have extensive experience working with some of the top hip surgeons nationwide in rehabilitating patients who have undergone these procedures. Treatment is guided by the referring physician’s protocol and the presentation of the patient and is aimed at returning the patient to their desired level of function and return to sport.
Iliotibial Band (IT Band) Syndrome– The IT Band runs along the lateral thigh and can cause pain from its origination at the lateral pelvis all the way to its insertion at the lateral knee. Overuse of the IT Band can be affected by weakened lateral hip musculature, poor lower extremity mechanics, or a more commonly a combination of both.
Tendinopathies– Tendons are the connections between a muscle and bone. The term tendinopathy can include both tendonitis (inflammation of the tendon) and tenosynovitis (degeneration of the tendon sheath and usually a progression of unresolved tendinitis.) Tendinopathies of the hip primarily occur in the hamstrings and glute tendons and are usually an overuse injury as a result of muscular imbalances and incorrect mechanics. Tendinopathies are usually very painful to stretch and use of the affected tendon.
Piriformis Syndrome– The piriformis muscle extends along the back and lateral side of the hip and can cause deep achy pain in sitting as well as walking or running. When this muscle is overused due to weak lateral hip musculature it can also compress the sciatic nerve and cause neural symptoms down into the lower leg.
Trochanteric Bursitis– The trochanteric bursa sits between the IT Band and greater trochanter. When the IT Band is too tight, it can rub on the bursa causing inflammation and irritation. This condition is often caused by degreased strength of the hip abductors or lateral hip musculature (glutes.)
Snapping Hip– Has 2 main causes: the IT band snapping over the head of the femur or the iliopsoas not able to stabilize the joint causing a click as the joint is moved through its range of motion.
Athletic Pubalgia– More commonly known as a sports hernia. This condition is characterized by a generalized groin pain that can spread to the inner thigh. The pain is usually aggravated by twisting, turning, or extending the hip. The hernia can occur in a number of lower abdominal insertions or fascial connections and can sometimes involve the ilioinguinal or genitofemoral nerve. This condition can be treated surgically or conservatively.
Post-partum Hip Related Issues– Many women experience hip pain that can be generated from the hip itself or stemming from other structures affected during the pregnancy as well as labor and delivery. Oftentimes the effects of the pregnancy are overlooked with a hip pathology and complete resolution cannot occur without consideration of the musculoskeletal changes that occur because of the pregnancy (pre-and post-natal.)
Nerve Specialties
Motion Stability is the leading rehabilitation clinic that treats nerve related symptoms such as: pinched nerves, sciatica, radiculopathies, complex regional pain syndrome and nerve pain from herniated discs. Nerves are commonly misunderstood as many people do not realize that they are a connective tissue, similar to a muscle, tendon, or ligament. Just as there are treatments for a muscle strain or a ligament sprain, there are techniques to treat nerve pain. Motion Stability has specialized training in nerve rehabilitation called ‘neurodynamics’ to treat the nervous system and its related parts. The Motion Stability staff is involved in clinical research, publications, and clinical training on nerve rehabilitation. Based on internationally renowned physiotherapist, Michael Shacklock, M.APP.Sc., Dip.Physio, we focus on three main areas to thoroughly treat nerve symptoms:
Whether it be a herniated disc, spinal degeneration, or fascial tightness in structures like the carpal tunnel, it is important to treat any physical structure that can compress or ‘pinch’ the nerve. Interventions such as traction, manual therapy, or medical interventions that can range from injections to surgery can reduce the pressure on the nerve and relieve its symptoms.
Even if the mechanical compression is relieved, patients may still have nerve symptoms. The residual symptoms are due to the nerve itself being left untreated. Nerves should be elastic enough – like a bungee cord – to lengthen in order to match your daily motion. However, with inflammation, the nerve becomes less elastic and more irritable with movements that extend it beyond its available motion. It is vitally important to improve the mechanics and physiology of the nerve, so that it is able to perform its intended function. In physical therapy, we utilize nerve mobilizations to improve the mechanics and physiology of the nerve.
Lastly, tissue that an inflamed nerve innervates can maintain nerve symptoms. This innervated tissue can manifest itself as fascial restrictions, muscle trigger points, and joint restrictions. It is important to improve the integrity of these structures as they are manifestations of the nerve’s system not working correctly and can perpetuate the dysfunction. Treatments can include, but are not limited to, manual therapy, appropriate exercises, and intramuscular manual therapy.